A Clinician's Guide to the Efficacy of EMDR Therapy

Abstract

Thirty years after its introduction in 1989, eye movement desensitization and reprocessing (EMDR) therapy has evolved to become a comprehensive psychotherapy, guided by Shapiro's adaptive information processing model. Her model views most mental health disorders as stemming from unprocessed earlier disturbing events. This understanding of the etiological role of trauma has opened the door for EMDR treatment of multiple types of presentations. There are now more than 44 randomized controlled trials that have investigated EMDR treatment of posttraumatic stress disorder (PTSD), early traumatic stress, and traumatized children. In addition, there are 28 randomized controlled trials which have evaluated its use with major depressive disorder, bipolar disorder, psychosis, anxiety disorders, obsessive compulsive disorder, substance use disorder, and pain. Seventy-five percent of these studies provided Shapiro's standardized procedure, while others tested modifications developed for specific populations. The focus of treatment varied across the studies, with various targets being processed to achieve good outcomes. The research demonstrates EMDR's effectiveness in reducing/eliminating PTSD and trauma-related symptoms, and in improving symptoms related to presenting problems and disorders. EMDR can be considered to have well-established efficacy for the treatment of PTSD. The emerging evidence for EMDR's efficacy with disorders other than PTSD must be considered preliminary and in need of replication conducted with randomized controlled trials using rigorous methodology. EMDR's position in various treatment guidelines is discussed, and the needs for future research are elaborated.